Replacement of (R)-methadone by a double dose of (R,S)-methadone in addicts: interindividual variability of the (R)/(S) ratios and evidence of adaptive changes in methadone pharmacokinetics.

Details

Serval ID
serval:BIB_2E37ACB0474F
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Replacement of (R)-methadone by a double dose of (R,S)-methadone in addicts: interindividual variability of the (R)/(S) ratios and evidence of adaptive changes in methadone pharmacokinetics.
Journal
European Journal of Clinical Pharmacology
Author(s)
Eap C.B., Finkbeiner T., Gastpar M., Scherbaum N., Powell K., Baumann P.
ISSN
0031-6970 (Print)
ISSN-L
0031-6970
Publication state
Published
Issued date
1996
Peer-reviewed
Oui
Volume
50
Number
5
Pages
385-389
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
Abstract
METHODS: Twenty-two patients receiving (R)-methadone maintenance treatment were switched to a double dose of (R,S)-methadone: blood samples were collected before and after the change, and the concentrations of the enantiomers were measured. In the second period, during racemic methadone treatment, important interindividual variability in the stereoselective disposition of the enantiomers of methadone was measured, with (R)/(S) ratios ranging from 0.63 to 2.40. This point should be taken into account particularly with respect to therapeutic drug monitoring of racemic methadone.
RESULTS: A significant decrease P < 0.005 in the mean serum concentration/dose ratios of the active (R)-enantiomer before and after the change was measured (mean 3.97 and 3.33).
CONCLUSION: Although of small amplitude (16%), this decrease confirms previously described adaptive changes in methadone pharmacokinetics during racemic methadone maintenance treatment and may necessitate, in some patients, a dose adjustment.
Keywords
Adult, Analgesics, Opioid/administration & dosage, Analgesics, Opioid/blood, Chromatography, High Pressure Liquid, Female, Humans, Male, Methadone/administration & dosage, Methadone/blood, Stereoisomerism, Substance-Related Disorders/blood, Substance-Related Disorders/rehabilitation
Pubmed
Web of science
Create date
01/03/2013 10:42
Last modification date
20/08/2019 13:12
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